Comparison of poststroke depression between acute ischemic and hemorrhagic stroke patients

Int J Geriatr Psychiatry. 2021 Apr;36(4):493-499. doi: 10.1002/gps.5444. Epub 2020 Nov 21.

Abstract

Objectives: Depression is the most common mental complication in stroke survivors with about one-third of patients suffering from poststroke depression (PSD). This was the first prospective study aimed to compare the prevalence of PSD and its symptoms between two cohorts of patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH).

Methods: Both AIS and ICH patients were simultaneously enrolled in the study. Depression symptoms were measured using the 17-item Hamilton Depression Rating Scale (HAMD-17) after a 1-month follow-up. Patients were diagnosed with PSD according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition and the HAMD-17 (HAMD scores >7).

Results: The prevalence of PSD (42.3%) in the ICH group was significantly higher than that (22.9%) in the AIS group (p < 0.001). After adjustment for conventional confounding factors, the odds ratio of PSD was 2.65 (95% CI, 1.34-5.24, p = 0.005) for ICH compared to AIS. Depressive symptoms consisting of anxiety, loss of interest, insomnia, and fatigue were more frequent in patients with ICH than in AIS patients.

Conclusions: PSD was more prevalent, and the risk was over twofold higher in patients with ICH than AIS.

Keywords: Hamilton Depression Rating Scale; acute ischemic stroke; intracranial hemorrhage; poststroke depression; symptomatology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Ischemia* / complications
  • Brain Ischemia* / epidemiology
  • Depression / epidemiology
  • Depression / etiology
  • Hemorrhagic Stroke*
  • Humans
  • Prospective Studies
  • Stroke* / complications